State of the World’s Children 2009 Report: Extreme Risks for Pregnant Women and Newborn Babies in Developing Countries
Speakers at the Bangladesh National Launch call for accelerating Bangladesh’s progress in saving mother and newborn lives
DHAKA, 29 January 2009 – In spite of Bangladesh’s significant progress in reducing child mortality, stronger efforts need to be invested in reducing maternal and newborn mortality in order to achieve Millennium Development Goals 4 and 5, speakers said at the Bangladesh national launch of UNICEF’s annual flagship publication the State of the World’s Children 2009 report in the city today. Mr. Sheikh Altaf Ali, Secretary, Ministry of Health and Family Welfare, was the Chief Guest of the event and Professor Dr. Shah Monir Hossain, Director General, DGHS the special guest. Mr. Carel de Rooy, UNICEF Representative in Bangladesh also spoke during the launch ceremony attended by a cross-sectoral audience of government and non-government stakeholders.
“Lowering a mother’s risk of mortality and morbidity directly improves a child’s prospects for survival,” said Mr. Sheikh Altaf Ali, Secretary, Ministry of Health and Family Welfare. “The Government is investing utmost efforts to improve the maternal and newborn health. Recently the national neonatal health strategy has been developed. The National Maternal Health Strategy is being updated and we seek to work together with all concerned stakeholders, including communities, development partners, professional organizations, NGOs, private sector, civil society and the media in order to accelerate progress.”
The report examines critical issues in maternal and newborn health, highlighting how the health and survival of mothers and their newborns are intrinsically linked. Many of the same interventions that save maternal lives can also benefit their infants. Africa and Asia are a key focus of the report as they account for 95 percent of maternal deaths and around 90 percent of newborn death in the world. The report also underlines the divide between industrialized countries and developing regions: women in the world’s least developed countries are 300 times more likely to die in childbirth or from pregnancy-related complications than women in developed countries.
Calling for a continuum of care approach by linking facility-based care with communities and households and delivering integrated services from antenatal care to postnatal care and early childhood, UNICEF Bangladesh Representative, Mr. Carel de Rooy said: “There have been important actions and interventions taken by the Government of Bangladesh such as equipping hospitals with comprehensive Emergency Obstetric Care. But addressing the health worker shortage is probably the main challenge that needs to be overcome if we want to reduce maternal and neonatal health.” Mr. de Rooy also appreciated the current efforts to revitalize community clinics. He also urged the Government to conduct a new Maternal health survey in order to obtain updated data and to design evidence-based programmes.
Speaking as the special guest of at the launch, Professor Dr. Shah Monir Hossain, Director General DGHS said, “The government has taken steps to integrate community-based interventions in order to reach mothers and newborns. For example, the National Nutrition programme has extensive activities in 109 upazillas. The Ministry of Health and Family Welfare is also piloting demand side financing in the form of maternal health voucher scheme in 33 upazillas to increase poor women access to utilization of quality maternal and neonatal services.”
According to Maternal Health Services and Maternal Mortality Survey 2001, maternal mortality ratio in Bangladesh is 320 per 100,000 lives births. This means about 12,000 women die from pregnancy and childbirth related complications every year.
Newborn mortality ratio is 37 per 1,000 live births which means 120,000 newborns die every year in Bangladesh in the first 28 days of life.
In Bangladesh, only 18% of births are attended by medically trained providers. 85% of births took place at home. Only one in five mothers and neonates receive postnatal care from a medically trained provider within 42 days after birth.
While many developing countries have made excellent progress improving their child survival rate in recent years, the same progress has not been made in addressing health risks for mothers, who are most vulnerable during delivery and in the first days after birth. And while the rate of survival for children under five years of age is improving globally, the risks faced by infants in the first 28 days remain at unacceptably high levels in many countries.
In the developing world, a woman has a 1 in 76 lifetime risk of maternal death, compared with a probability of 1 in 8,000 for women in developed countries. Approximately 99 percent of global deaths arising from pregnancy and complications occur in the developing world, where having a child remains among the most serious health risks for women. The vast majority occur in Africa and Asia, where high fertility rates, a shortage of trained personnel and weak health systems spell tragedy for many young women.
The ten countries with the highest lifetime risk of maternal death are Niger, Afghanistan, Sierra Leone, Chad, Angola, Liberia, Somalia, the Democratic Republic of Congo, Guinea-Bissau, and Mali. A woman’s lifetime risk of maternal death in these countries ranges from 1 in 7 in Niger to 1 in 15 in Mali.
And for every woman who dies, another 20 suffer illnesses or injury, often with severe and lasting consequences.
To lower maternal and infant mortality, the report recommends essential services be provided through health systems that integrate a continuum of home, community, outreach and facility-based care.
This continuum of care concept transcends the traditional emphasis on single, disease-specific interventions, calling instead for a model of primary health care that embraces every stage of maternal, newborn and child health.
The report finds that health services are most effective in an environment supportive of women’s empowerment, protection, and education.
For more information see: www.unicef.org.bd or www.unicef.org/sowc09
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